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Cognitive Analytic Therapy (CAT) is a type of talking therapy that combines elements of cognitive and analytic practice. CAT focuses on conscious thoughts and beliefs with the exploration of unconscious processes, early life experiences and interpersonal relationships. This therapy believes that the relationships and events in an individual’s life influence their thoughts and feelings. It operates on the premise that an individual’s life experiences shape both, their interpersonal relationships, as well as their self-perception. CAT emphasises a collaborative relationship between the therapist and the client. Together, they work to identify and understand the client’s problematic patterns of thinking and behaving.

In the context of CAT, reformulation is a central concept. It refers to the process of creating a written diagram or map that illustrates an individual’s patterns of thinking, feeling and behaving in relation to their emotional and psychological difficulties. This diagram is a visual representation of the person’s psychological landscape and interpersonal dynamics and is designed to promote self-awareness, insight, as well as therapeutic change. CAT is a time-limited from of talking therapy which means that it focuses on a limited number of target problems that the client wants to address. Since CAT is time-limited, it is also goal-oriented and aims to help clients make specific changes in their lives.

hands touching cognitive analytic therapy

How does CAT Work?

Cognitive Analytic Therapy takes a structured and collaborative approach with the aim of helping individuals understand and change their patterns of thinking, feeling and behaving to improve the way they relate to themselves and the people in their life. Here is an overview of how CAT works:

Assessment and Problem Identification: The therapy sessions begin with an assessment phase during which the therapist and client work together to identify the client’s main difficulties and concerns. These are referred to as “target problems”, and the focus of the sessions as well as the goal setting remains on these identified target problems. During this phase of the process, the therapist will also gather information about the client’s personal history, current circumstances and relationships to get a deeper understanding of problems and difficulties outlined.

Reformulation: This step is central in the process of CAT. It involves creating a written diagram or map that illustrates the client’s patterns of thinking, feeling and behaving in relation to their target problems. The function of reformulation is typically to identify key roles and patterns that the client adopts in their life, with a specific focus on early experiences and relationships. 

Recognising Patterns: With the help of the previous step, the client and the therapist work collaboratively to trace the recurring patterns that contribute to the target problems. These patterns can include a series or type of unhelpful thoughts, emotions, behaviours and interpersonal dynamics.

Building Awareness: In this step of the process, the therapist helps increase the client’s awareness of patterns and their impact on the client’s wellbeing and relationships. This increased awareness is a crucial step as it results in resolving the target problems.

Target Problem Procedures: The therapist helps the client develop strategies to change their problematic patterns and adopt more adaptive and helpful ways of thinking, behaving and feeling.

Testing and Homework: Client is encouraged to test new ways of approaching their target problems in real-life situations. They may be assigned tasks as homework to practice and implement the changes discussed in therapy.

Time-Limited and Structured: CAT is a time-limited therapy with predetermined number of sessions (which the therapist discusses and decides collaboratively with the client). The sessions can be anywhere between 16 and 24, on a weekly basis and are usually 50-60 minutes long. The structured characteristic of CAT helps create a sense of focus and urgency in working on the identified issues.

Ending and Closure: CAT places importance on the ending phase of therapy. This includes a formal closure process in which the therapist and client reflect on the progress made and prepare for a life without therapy. This final step in the process is an opportunity for the client to consolidate their gains and develop strategies for managing their problems self-sufficiently in the future.

During the course of the therapy, the therapist will be collaborative and supportive in their approach to resolve the target problems. This helps the client gain insight into their difficulties and develop more adaptive ways of coping. The focus on patterns and interpersonal relationships is a distinctive feature of CAT, allowing the client to assess the origins as well as current impact of their problems. The end goal of CAT is to equip the client to adopt healthier ways of coping in the future without the need of therapy once the treatment comes to an end.



Helps gain a deeper understanding of one’s patterns of thinking, feeling and behaving and encourages self-awareness

Makes one participate actively in the process, thereby helping them see its effect as therapy progresses

Improves one’s interpersonal relationships and quality of life

Enables one to take charge of their problems and make lasting changes in their lives

Feeling more able to engage in relationships and enjoy pleasurable activities

Equips one with lifelong healthy coping techniques




Personality Disorders


What is the difference between CAT and CBT?
CAT primarily focuses on relationship patterns that an individual cultivates over the years, these patterns can be both unhealthy or healthy. Whereas CBT is a therapy that focuses on identifying troublesome patterns of thinking, to subsequently rectify the feelings and behaviour of an individual. Moreover, CBT is largely focused on the thoughts and feelings in the here and now, whereas CAT is a therapy that delves into the past.
How effective is CAT?
Like other types of talking therapies, the effectiveness of CAT can vary depending on the individual and their specific needs, but it has been found to be helpful for many people seeking to address their emotional and interpersonal challenges.
Are there any risks involved with CAT?
CAT is generally considered a safe and effective form of psychotherapy. However, as with any psychological treatment there are some potential risks, which can be in the form of:

  • Emotional discomfort that might arise from talking about personal and emotionally intense experiences
  • Resistance or hesitance in sharing personal details of your life with the therapist, which may delay the progress
  • Challenges that you might face upon making certain changes in your relationships that are better for you but might be disliked by some people in your life